Recommended Dr for Amnio

[Tuli666]

Hi,
I am 39 and my first trimester screening was 1:3000 for T21 and 1:20000 for T18 and T21. Although we are 'low chance' we are finding it difficult to relax and thinking about having amnio. Can anyone recommend a Dr in London for the procedure?
Many thanks!

Would you be paying for this? Would it not be better to have a NIPT/Harmony Test, which has no risk attached? Amnio has 1% risk of miscarriage.

Low risk also means that despite your age your bloods and baby's measurements are pretty good.

Yes I will have to pay for the amnio. I was seriously considering NIPT but now that I understand it is only a screening test and not diagnostic, I am thinking that if the NIPT would come back with a similar result (1:3000) I will still be worried...

@crabbyPatty thinking about what you just wrote, do you think that if I was younger I would get lower risk results with the same bloods and measurements?

I was 43 when I had my first so I completely sympathise with your concerns. But with the amnio you will be exchanging one set of worries (at c.1:3,000 risk of a trisomy) for another set of concerns (at only 1:100 risk of miscarriage caused by the amnio). Perhaps if you look into the HIPT/Harmony you might think it would be enough to put your mind at rest, it certainly did me. Good luck.

I would go for the NIPT. It's not technically diagnostic but it will either come back as 1:2 risk (I would then get the amnio) or 1:10,000 which means baby doesn't have a trisomy so it is near as damn it to diagnostic and there is zero risk of miscarriage unlike the (small) risk that comes with an amnio

I do understand the concern. My risk was virtually identical to yours and they are very low risk results but I was still anxious so I had the Harmony NIPT test. I wouldn't have had an amnio if it didn't exist though

I would absolutely go for NIPT before even starting to consider an amnio. Those risks just do not stack up against the MUCH higher risk of miscarriage as a result of the amnio. As others have said, if there are any trisomies they will be indicated by the NIPT and then could be confirmed by amnio. But really though with those screening risks at 39 you really have nothing to worry about.

Are you seriously considering a non-negligible risk of miscarriage because you're still anxious after a very low risk result from screening? Do you realise that's crazy?

Even if you got the amnio and it was clear for the trisomies, your baby could still be born with another syndrome or disability. There's no way to rule it out altogether. By all means get the NIPT if you want further testing, but opting for an amnio is, from a risk perspective, bonkers and suggests that it may be more fruitful to deal with your anxiety at the source.

Your results are excellent, I wouldn’t bother with further tests if I were you.

For reference, I’m 27 and my downs results were 1 in 3783 for Down’s syndrome so not massively different.

I guess you are right and I should consider the NIPT first.
The reason I wasn't sure about it is it's only 97-99%. I know it is highly accurate but there is 1-3% chance..
Unfortunately I was that 1% in previous medical procedure where only 1% don't recover well and it caused my infertility.. So I think I am worried I will be that "one" again..

You're not comparing the numbers accurately, OP. NIPT detects 98+% of babies with Downs, Pataus or Edwards syndrome. Let's take Downs as the most common. The risk of your baby having Downs (based purely on your age) AND the NIPT missing it is 1:110 x 0.02 or 1:5500. And with low results already from the 12 week screening the probability of Downs being there AND missed by the NIPT is way lower than this, maybe one in hundreds of thousands. The numbers are higher for Edwards or Pataus. Whereas whether your baby has a triploidy or not, the chances of miscarriage after amnio are a straight 1:100.

In very simple terms, you would be far far far more likely to miscarry a healthy baby if you had amnio over NIPT than you would be to pick up a triploidy that would be missed by NIPT. I wouldn't be surprised if you couldn't find a doctor to agree to do it on an ethical basis.

You need to deal with the anxiety as that is the driver in this. Having the procedure will not reassure you. You will then start to worry that you will miscarry. You are likely to just move your anxiety on to another aspect of the pregnancy once you have your normal amino result.
If you are considering amnio with your low risk results, it would be worth speaking to your GP generally.
Also, any doctor worth seeing would not perform an amnio as it is likely to be unethical to do so as it would be for parental reassurance and not in the baby's best interests.

I'd also suggest NIPT. We did this as I was pregnant after several rounds of ivf and just couldn't accept that things were finally working out for me. If you are near London I highly recommend the Fetal Medicine Centre on Harley St.

I would strongly recommend that you go for a consultation at the Fetal Medicine Centre on Harley Street if you are anywhere near London. They can talk you through the harmony test and if you decide to go ahead with amnio I seem to remember that Professor Nicolaides has statistically the best record with amnio... way below the usual average for miscarriage.

Thanks all for your thoughts and advice x x

OP anything over 95% statistically is good as nothing in life is 100%.

I agree with @flakebaby that you need to see a doctor about your anxiety as you will direct it onto something else on your pregnancy once the NIPT test comes back saying everything is fine. There are posters who come on here who think everything they have eaten will give them food poisoning and harm their baby, or doing X, where X is a normal everyday activity, will harm their baby.